Healthcare Provider Details

I. General information

NPI: 1730405416
Provider Name (Legal Business Name): MS. SALLY JANE PLONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SALLY BROWN M.A.

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 04/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 LANGLEY RD
NEWTON MA
02459-1909
US

IV. Provider business mailing address

49 CHARLES ST
AUBURNDALE MA
02466-1709
US

V. Phone/Fax

Practice location:
  • Phone: 617-593-7344
  • Fax: 866-826-3011
Mailing address:
  • Phone: 617-593-7344
  • Fax: 866-826-3011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH3346-CC
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMH3346-CC
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: